breastfeeding advocacy

Whistleblower: Infant formula companies boldly violating WHO code, smearing breastmilk

“Imagine that the world had created a new ‘dream product’ to feed and immunize everyone born on Earth. Imagine also that it was available everywhere, required no storage or delivery, and helped mothers plan their families and reduce the risk of cancer. Then imagine that the world refused to use it.” ~ the late Frank Oski, MD, American pediatrician

That “dream product” this renowned child nutrition expert was referring to before his 1996 death from prostate cancer already exists—in breastmilk.

Breastmilk delivers lifelong health benefits to infants that far outweigh substitutes, doubling as both a source of superior nutrition and immunization to disease. Breastfeeding also plays a major role in establishing a foundation for infant mental health, secure mother-infant attachment, and strong family relationships.

Yet, breastmilk is routinely pitted against the marketing prowess of multi-billion-dollar infant formula companies that in recent years at least have promoted its use as supportive to breastfeeding rather than an alternative.

This seemingly complementary role of formula to breastfeeding, as marketed, is a rather new change in course in the history of infant formula—mostly out of “regard” for the WHO’s International Code of Marketing Breast-milk Substitutes, enforceable by law in 136 of 194 developed countries.

Formula companies aren’t foolish when it comes to making money. Even formula companies in the 58 countries that do not prioritize the WHO code in their advertising legalese understand the potential damage to sales that could come with marketing formula as equal to or better than breastmilk in a culture that values advocating for higher breastfeeding rates.

This month, the United Kingdom-based infant formula company Bobbie debuted a national U.S. marketing campaign on the first day of World Breastfeeding Week (Aug. 1-7, 2021) with a full-page ad in the New York Times that so flagrantly broke the WHO code that there should be outrage from all levels of U.S. breastfeeding support.

The silence is telling. Only one instance of social pushback against this formula company’s challenge to “breast is best” has made it to the top of search-engine lists:

“Unethical food marketing ad of the week: infant formula, organic no less” by Marion Nestle (no relation to Nestle products), Food Politics.

Social media can be a powerful force for good when in the hands of empowered parents.

Well-supported breastfeeding parents are empowered. That support comes from many levels, from La Leche League International leaders to International Board Certified Lactation Consultants to media and culture to societal systems. In the United States, breastfeeding support has long been making gains on an uphill climb. We are not done by any means, as we live in a system that does not put family first.

Yet something has shifted in breastfeeding support internationally, and we are in danger of losing those gains.

Maybe we have become complacent. Maybe we have allowed our capitalistic economy to trump decades of research showing that breastmilk is truly best. In 2018, the U.S. threatened countries with economy-crushing tactics to avoid adopting a United Nations resolution to protect, promote, and support breastfeeding. This bewildering rejection of breastfeeding was justified by then-President Donald Trump as a show of support for mothers.

The news media was then relatively quiet in 2019, before COVID-19 struck in 2020—leaving billions of mothers around the world stranded from breastfeeding support, with the pandemic continuing to compromise face-to-face lactation support in the early weeks after childbirth when breastfeeding challenges are most likely to arise.

Infant formula companies filled the gap with questionable claims and overt WHO code violations:

In Paraguay, Danone specifically promoted its Nutricia infant formula as the safe infant-feeding method, purporting that COVID-19 could be transmitted to babies via breastfeeding. Danone extended this so-called support to “babies born in the pandemic” in Brazil, India, and parts of Europe.
In Mexico and Peru, Abbott claimed its brand Similac strengthens babies’ immune systems against viruses and bacteria.
In Southeast Asia, Nestle’s Indonesian brand Dancow ran ads portraying children drinking formula with the tagline (translated): “Mother, protect your sweetheart!”
Likewise, Danone’s Indonesian brand SGM promoted a “customer care line” via its Instagram and WhatsApp social media channels, and urged mothers to call with questions about child growth and development.
In both Pakistan and India, Nestle’s Lactogrow has been distributed in COVID-19 relief packages.

These and other instances are enough of a red flag that, globally, breastfeeding is on a slippery slope toward losing relevance—again.

Our grandmothers remember when breastfeeding rates dipped to near nonexistence in the U.S. between 1940 and 1970. Less than a century is not so long ago. We need a resurgence of impassioned support of breastfeeding, especially as the COVID-19 pandemic has allowed infant formula companies an opportunity to step up their marketing schemes against breastfeeding—which is as much against mothers and fathers, their infants’ health, and a confident beginning for the family.

After the struggles that breastfeeding had to endure to overcome formula companies’ misinformation in the 20th century, breastfeeding is not nearly as established as it needs to be in our society to be left to stand on its own against capitalism’s continued manipulation of the public when left unchecked.

We look forward to seeing, and sharing, empowered parents’ protection, promotion, and support of breastfeeding.

WBW 2016: 5 tips for a strong nursing relationship while working away from home

Editor’s note: Among the 17 Sustainable Development Goals central to World Breastfeeding Week this year is a call for better workplace support of breastfeeding women. Certainly employers have a large part to play in meeting this goal, but women also need step up to advocate for themselves, their babies, and their right to express breastmilk while at work:

It’s that day…the dreaded day that no new mother wants to face — the last day of maternity leave.

For a mother able to take 12 weeks of unpaid leave afforded by the Family & Medical Leave Act, the last 3 months in baby bliss may instead feel like 3 short weeks, but regardless of the maternity leave length, the end of that special period arouses many emotions, especially for a nursing mother.

Naturally, a nursing mother’s mind becomes occupied with fears and questions:

How will I be able to provide enough milk while I am away?
What if my baby refuses a bottle?
Where will I find enough time to pump while I’m trying to work?
How will my boss and coworkers feel when I need time to pump?
What will happen to our nursing relationship?

This uncertainty creates even more stress and anxiety for the breastfeeding and working-away-from-home mother for she knows the important role breastfeeding plays in a secure attachment in addition to the numerous health benefits.

Continued nursing after the maternity leave period helps maintain a strong attachment between mother and baby. In his book, The Attachment Parenting Book, Dr. William Sears includes a chapter entitled “Working and Staying Attached,” in which he points out that giving your baby your milk is a very important way of staying attached to your baby after returning to work. Expressing milk for baby to drink during the day allows mother to, in a sense, be with baby while she is away at work. When mother and baby are reunited, their attachment through breastfeeding can resume as if she never left.

Nursing beyond maternity leave not only helps strengthen attachment but also provides numerous health benefits for the nursing mother and her nursling. In 2012, The American Academy of Pediatrics (AAP) published their policy statement, “Breastfeeding and the Use of Human Milk,” in Pediatrics. In this document, the AAP notes the numerous benefits of nursing, including those of nursing beyond 3-4 months. Some of these benefits for baby include a lower risk for developing serious colds, asthma, and other allergies; Sudden Infant Death Syndrome; and childhood and adult obesity. For the nursing mother, benefits include a lower risk of diabetes for mothers not diagnosed with gestational diabetes, a lower chance of arthritis, and breast and ovarian cancers. Essentially, the longer a mother can provide her baby with mother’s milk, the more health benefits received by both mother and baby.

In order to continue a secure attachment and experience the health benefits of breastfeeding, nursing mothers can maintain a strong nursing relationship while working away from home by following a few simple tips:

Know your breastfeeding rights — Under the Patient Protection and Affordable Care Act, many U.S. employers must provide a nursing mother with break time and a place to pump for up to 1 year after the birth of her baby. It is to be noted that companies with less than 50 employees are exempt from this law and instead offer pumping breaks at the discretion of the employer. Information, along with instructions for filing a complaint, can be found through the United States Department of Labor. Many other countries have generous allowances for nursing mothers at work, so be sure to check with your nation’s laws.
Plan a pumping schedule — This schedule will differ from mother to mother. Planning to nurse right before being separated from baby and as soon as mother and baby are reunited can help reduce the amount of pumping sessions needed at work. While at work, a mother should try to pump about every 3-4 hours. For a mom working an 8-hour shift, she might pump once in the morning, once during her lunch, and once in the afternoon. The idea is that for each time baby receives expressed milk from his or her care provider, mother is pumping. In doing this, mother should be able to pump the amount of milk that baby will consume the following day. Talk with a local breastfeeding specialist for a pumping schedule tailored to your work environment and other needs.
Discuss needed accommodations with employer — When a mother meets with her employer, she should be prepared by knowing her legal rights. A working-away-from- home mother should inform her employer of the needed accommodations before returning to work. The employer may need some time to make changes in order to accommodate the nursing mother. When the mother meets with her employer, she should provide her employer with a copy of her nursing schedule. This may also include pumping space accommodations. For example, the room where milk will be expressed needs to have an easy-to-access electrical outlet and should be heated and cooled.
Nurse on demand — Although a working mother must have a pumping schedule while at work, at home, she can nurse her baby on demand. Nursing on demand means that a nursing mother nurses when cued by the baby. This might be every 30 minutes or every 2 hours. Since how much milk produced is based on demand, a nursling can help increase a mother’s supply by nursing frequently. Nursing on demand also allows baby to re-establish the nursing bond that was missed during the day. Nursing on demand can continue during the night. Frequent night nursing may lead to reverse cycling, meaning the baby will nurse more frequently during the night than he or she does during the day. Some mothers who encourage reverse-cycling find that they don’t need to pump as much while at work during the day. For example, a baby may only drink 4-5 ounces of milk while his or her mother is at work, but the remaining amount of milk needed will be attained during the evening and all through the night. Essentially, in 24 hours, the baby will have consumed his or her total amount of milk needed.
Get support — Most nursing mothers need support throughout the breastfeeding journey, and nursing mothers that work away from home are no exception. La Leche League International and other nonprofit organizations provide local and online opportunities for mothers to connect and support each other.

While the end of maternity leave marks a transitional period for mother and baby, a strong nursing relationship can be maintained by carefully preparing for this changed and remaining dedicated to the desire to nourish baby with mother’s milk.

Thank you, La Leche League

Mary White, Edwina Hearn Froehlich, Mary Anne Cahill, Betty Wagner Spandikow, Viola Brennan Lennon, Mary Ann Kerwin, Marian Leonard Tompson — while these 7 names may not ring a bell, what they did has influenced so many lives all around the world. These 7 ladies founded La Leche League International (LLLI).

It’s because of LLLI that we celebrate World Breastfeeding Week each year!

La Leche League International is an organization that promotes breastfeeding. Its mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.

Elaborating on their mission, LLLI’s philosophy is comprised of 10 statements:

Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.
Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.
In the early years, the baby has an intense need to be with his mother, which is as basic as his need for food.
Human milk is the natural food for babies, uniquely meeting their changing needs.
For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids — about the middle of the first year after birth.
Ideally the breastfeeding relationship will continue until the baby outgrows the need.
Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.
Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby’s father. A father’s unique relationship with his baby is an important element in the child’s development from early infancy.
Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.
From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.

With a vision of what breastfeeding could and should be, a mission was created, principles stated, and an organization that would change the world of breastfeeding became: La Leche League.

With a decline in breastfeeding rates, the first La Leche League meeting took place in Franklin Park, Illinois, USA, at the home of cofounder Mary White in October 1956. As the organization began to grow, the founders set a clear purpose, and the first edition of book, The Womanly Art of Breastfeeding was published.

In 1960, the first Canadian Le Leche League was established. Two years later, “chapters” were created with 5 groups in each. By 1963, the second edition of The Womanly Art of Breastfeeding made an appearance. By 1964, the group changed its name to Le Leche League International as the organization has spread to Canada, Mexico, and New Zealand. This year also marked the first LLLI conference. From 1972-1979, more Le Leche League organizations were established throughout Europe, and breastfeeding rates were improving. In 1981, the 25^th Anniversary LLLI Conference was held with a record number of attendees, and the third edition — revised and expanded — of The Womanly Art of Breastfeeding was published. Throughout the 1980s, LLLI published various books. Then, in 1985, the International Board of Lactation Consultant Examiners — created through help from LLLI — began its certification program, and the first IBCLC exam took place.

Although breastfeeding rates had increased to 61.9% in the early ’80s, by 1990, the rate had dropped to 50%, and in 1991, LLLI and other organizations and individuals came together to create the World Alliance for Breastfeeding Action. The first World Breastfeeding Week took place in 1992. In 1994, LLLI moved its central office to Schaumburg, Illinois, USA, and the following year, the LLLI website was created. Breastfeeding rates increased to nearly 60%.

During the first decade of the 21^st century, LLLI continued to grow, accrediting new leaders in various countries including Bulgaria and Ukraine. In 2006, the 50^th Anniversary of LLLI was celebrated, and in 2009, LLLI created a Facebook page. In 2010, the 8^th edition of The Womanly Art of Breastfeeding was released not only in English but other languages. Since then, LLLI has continued to accredit leaders in countries, helping the organization grow and spread its important mission.

As we celebrate World Breastfeeding Week, we acknowledge LLLI’s notable contribution to breastfeeding and also recognize the extraordinary women, the founders of LLLI, for their initiative and hard work making LLLI what it is today.

Breastfeeding is everyone’s business

“Thriving communities are built on strong families and a strong workforce. Breastfeeding promotes both. Breastfeeding promotes strong families by giving kids a healthier start in life, less risk of illness and disease. It helps mothers be healthier. There’s less risk of postpartum depression, lower risk of breast and ovarian cancer, and it supports strong bonds between the family, both emotional and psychological. Breastfeeding also promotes a strong workforce with decreased employee absenteeism to care for ill children, increased employee morale and decreased employee turnover. Breastfeeding benefits communities, so it’s time for communities to support breastfeeding.” ~ Dr. Jenn Anderson, “Breastfeeding is everyone’s business”

Editor’s note: “Breastfeeding is everyone’s business” is a TEDx Talk by Jenn Anderson, PhD, Assistant Professor at South Dakota State University (SDSU) in Brookings, South Dakota, USA. Dr. Anderson’s personal breastfeeding experience has influenced her professional interest; among her current projects are Brookings Supports Breastfeeding and expanding Brookings Health System’s prenatal education to the SDSU campus. Dr. Anderson was invited by Attachment Parenting International to share more about her perspective in breastfeeding advocacy:

By Jenn Anderson, PhD, SDSU Assistant Professor of Health Communication

Breastfeeding benefits our communities by improving maternal and infant health. It also boosts our local economies through cost savings for businesses with breastfeeding employees that miss work less often and whose children have lower health care costs.

Breastfeeding is benefiting our communities; now we need our communities to support mothers who are breastfeeding.

I strongly believe in giving women the freedom and support they need to make the best decisions for themselves and their families.

When social or structural support for breastfeeding is absent, this can create unnecessary barriers to mothers breastfeeding successfully. I want every woman to feel that it is possible to breastfeed her child successfully, and I want to see entire communities work together to support those efforts.

Breastfeeding my premature son has been one of the greatest joys of my life. But I know that not all women have the opportunity to breastfeed at all, or they must stop breastfeeding sooner than they’d like because they don’t have the support they need at work, or from their spouse, or from their friends and family.

I want every woman to have the support she needs to be able to embark on the breastfeeding journey and see it through until she and her baby are ready to stop.

I also want to encourage more women to publicly breastfeed so that our friends and neighbors understand the true nature of breastfeeding — that it is normal, non-sexual and unobtrusive.

Breastfeeding in public is sometimes seen as taboo, but in this presentation, I show how it seamlessly becomes part of life as a mother, as a professional and as a citizen of a small community.